Stairway to heaven or a placebo: the impact of lean leadership, through job demands, on hospital workers' engagement and performance.

PURPOSE: This study aims to examine to what extent the relationships between hospital workers' perceptions of lean leadership behaviour, their engagement and the hospital unit's perceived performance are mediated by job demands. DESIGN/METHODOLOGY/APPROACH: The data (n = 1,624) come from a lean implementation study in a Dutch hospital and are analysed using structural equation modelling in Mplus (v8.4). FINDINGS: The results confirm that lean leadership behaviour is related to employee engagement and hospital unit performance as perceived by employees, and these relationships are partially mediated through job demands. More specifically, the authors found that the type of job demand explains the direction of mediation effects. On the one hand, so-called challenging demands positively mediate the relationships between lean leadership behaviour and its outcomes. Conversely, hindering demands negatively mediates the relationship between lean leadership behaviour and perceived unit performance. PRACTICAL IMPLICATIONS: The authors recommend hospital organisations and human resources managers start by helping hospital leaders understand the underlying mechanisms that explain the effects of leadership on employees' perceptions and, second, support their frontline leaders by providing training, coaching and feedback on how to influence job demands in a way that creates an optimal work environment for hospital employees. ORIGINALITY/VALUE: The authors contribute to the literature by building upon insights from the job demands-resources model to explain the effects of lean leadership behaviour and by investigating the relevance of lean leadership in a hospital context, given the phenomenon's strong roots in manufacturing.

Stimulating Employability and Job Crafting Behaviour of Physicians: A Randomized Controlled Trial.

The demanding work context of physicians challenges their employability (i.e., their ability and willingness to continue to work). This requires them to proactively manage their working life and employability, for instance, through job crafting behaviour. This randomized controlled intervention study aimed to examine the effects of a personalized feedback report on physicians' employability and job crafting behaviour. A total of 165 physicians from two hospitals in a large Dutch city were randomly assigned to a waitlist control or intervention group in May 2019. Physicians in the intervention group received access to a personalized feedback report with their employability scores, suggestions to improve these and to engage in job crafting. Participants completed a pre-test and eight weeks later a post-test. RM MANOVAs and RM ANOVAs showed that the intervention enhanced participants' perceptions of their mental (F (1,130) = 4.57, p < 0.05) and physical (F (1,135) = 16.05, p < 0.001) ability to continue working. There was no effect on their willingness to continue to work. Furthermore, while job crafting behaviour significantly increased over time, the personalized feedback report did not account for this change. This low-investment intervention is relevant for organizations to stimulate employees' proactivity and create positive perceptions of their ability to continue to work. Moreover, this study contributes to the literature by examining a novel approach of a job crafting intervention that does not require many resources to implement.

Positive impact of the COVID-19 pandemic? A longitudinal study on the impact of the COVID-19 pandemic on physicians' work experiences and employability.

OBJECTIVE: The COVID-19 pandemic places an enormous demand on physicians around the world. The aim of this study was to examine the impact of the COVID-19 pandemic on physicians' work experiences and their ability and willingness to continue working in their profession until retirement (ie, their employability). DESIGN: A longitudinal comparative design was used. Survey data were collected on three moments: before (May 2019), in the early phase (May 2020) and in a later phase (November 2020) of the COVID-19 pandemic. Time effects were tested using repeated-measures analyses of variance and one-way analyses of variance. SETTING: This study took place among physicians of two hospitals in a large city in the Netherlands. PARTICIPANTS: 165 hospital physicians with surgical, medical and other specialties participated in this study. RESULTS: Physicians' employability significantly increased from the time prior to the COVID-19 pandemic, compared with the period during this pandemic. Employability differs among physicians with surgical, medical and other specialties. Furthermore, physicians experienced a lower emotional, physical and quantitative workload during the first peak of the COVID-19 pandemic, compared with before the pandemic. Moreover, physicians experienced the most stress from the impact of COVID-19 on their work in general and from combining work and private life. CONCLUSIONS: This study shows that physicians' employability and work experiences are affected by the COVID-19 pandemic. Work experiences vary for physicians with different specialties. These varieties stress the importance of attention for physicians' individual needs and challenges regarding working during the COVID-19 pandemic and the possibility of continuing work in the aftermath of this crisis. Based on this, physicians can be offered tailor-made solutions. This is important to maintain a healthy and employable workforce, which is essential for a sustainable healthcare system.

A Career Crafting Training Program: Results of an Intervention Study.

This intervention study examined the effects of a career crafting training on physicians' perceptions of their job crafting behaviors, career self-management, and employability. A total of 154 physicians working in two hospitals in a large Dutch city were randomly assigned to a waitlist control group or an intervention group. Physicians in the intervention group received an accredited training on career crafting, including a mix of theory, self-reflection, and exercises. Participants developed four career crafting goals during the training, to work on in the subsequent weeks, after which a coaching conversation took place over the phone. Physicians in the control group received no intervention. A pre- and post-test 8 weeks later measured changes in job crafting and career self-management (primary outcomes) and employability (secondary outcome) of 103 physicians that completed the pre- and post-test. RM ANOVAs showed that the intervention enhanced perceptions of career self-management and job crafting behavior to decrease hindering job demands. No support was found for the effect of the intervention on other types of job crafting and employability. This study offers novel insights into how career crafting can be enhanced through training, as this is the first empirical study to examine a career crafting intervention. HR managers can use the outcomes to develop tailored career policies and career development practices.

Career Crafting Training Intervention for Physicians: Protocol for a Randomized Controlled Trial.

BACKGROUND: Physicians work in a highly demanding work setting where ongoing changes affect their work and challenge their employability (ie, their ability and willingness to continue working). In this high-pressure environment, physicians could benefit from proactively managing or crafting their careers; however, they tend not to show this behavior. The new concept of career crafting concerns proactively making choices and adapting behavior regarding both short-term job design (ie, job crafting) as well as longer-term career development (ie, career self-management). However, so far, no intervention studies have aimed at enhancing career crafting behavior among physicians. Given that proactive work and career behavior have been shown to be related to favorable outcomes, we designed an intervention to support career crafting behavior and employability of physicians. OBJECTIVE: The objectives of this study were to describe (1) the development and (2) the design of the evaluation of a randomized controlled career crafting intervention to increase job crafting, career self-management, and employability. METHODS: A randomized controlled intervention study was designed for 141 physicians in two Dutch hospitals. The study was designed and will be evaluated based on parts of the intervention mapping protocol. First, needs of physicians were assessed through 40 interviews held with physicians and managers. This pointed to a need to support physicians in becoming more proactive regarding their careers as well as in building awareness of proactive behaviors in order to craft their current work situation. Based on this, a training program was developed in line with their needs. A number of theoretical methods and practical applications were selected as the building blocks of the training. Next, participants were randomly assigned to either the waitlist-control group (ie, received no training) or the intervention group. The intervention group participated in a 4-hour training session and worked on four self-set goals. Then, a coaching conversation took place over the phone. Digital questionnaires distributed before and 8 weeks after the intervention assessed changes in job crafting, career self-management, employability, and changes in the following additional variables: job satisfaction, career satisfaction, work-home interference, work ability, and performance. In addition, a process evaluation was conducted to examine factors that may have promoted or hindered the effectiveness of the intervention. RESULTS: Data collection was completed in March 2020. Evaluation of outcomes and the research process started in April 2020. Study results were submitted for publication in September 2020. CONCLUSIONS: This study protocol gives insight into the systematic development and design of a career crafting training intervention that is aimed to enhance job crafting, career self-management, and employability. This study will provide valuable information to physicians, managers, policy makers, and other researchers that aim to enhance career crafting. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/18432.

Dealing with a changing work environment: hospital job type contingencies.

Purpose The purpose of this paper is twofold: first, to examine whether workers in various hospital job groups differ in their perceptions of the provision of managerial support, and of their up-to-date expertise (UDE), willingness to change (WTC) and employment opportunities (EO). Second, to examine whether and how the relationships between managerial support, workers' UDE, WTC and their EO are moderated by hospital job type. Design/methodology/approach Survey data were collected from 1,764 employees of three Dutch hospitals. ANOVAs and structural equation modeling were used to test the hypotheses. Findings The research findings indicate significant differences between the hospital job groups with regard to UDE, WTC and EO. No support was found for differences on managerial support nor for a moderating effect of hospital job type. The latter means that the relationships of managerial support with workers' UDE, WTC and EO are independent of job type. Originality/value Based on the findings, a classification system is constructed that shows how hospital workers' UDE, WTC and EO can be explained by the combination of the educational level required by a job and its degree of specialization.